What Are the Treatment Times for Tens When Attempting to Modulate Pain?

Introduction

There are many kinds of Electrophysical Agents (EPAs) that rehabilitation practitioners may use. You may recall racking your brain while learning about EPAs in school, trying to understand how they work, how to use them, and contraindications to their apply. In this blog, we will provide y'all with a basic overview of common EPAs, including what they are, what they are used for, likewise as their parameters and contraindications. At that place is a nautical chart included at the stop of this blog with a summary of parameters for mutual EPAs.

It is of import to note that there is limited evidence supporting the utilize of EPAs and variation in recommended parameters. Therefore, it is imperative that clinicians use their clinical reasoning alongside available testify and practice guidelines in order to make the best decisions and recommendations for each of their patients. Additionally, with many EPAs, at that place is a take chances of tissue damage if non used appropriately. Call back to conduct frequent skin checks and inquire your patient to written report if they feel discomfort. Practise not utilize EPAs to a patient that has sensory or cerebral impairments that will make it difficult for them to experience or communicate if they are experiencing discomfort.

Thermal Agents

Rut

What is it?

Oestrus agents refer to modalities that estrus the skin and superficial tissues inside one-2mm. Some examples are a hot pack, whirlpool bath, hot wax, contrast baths, and fluidotherapy.

What is it used for?

Heat modalities are used to relieve hurting by stimulating A-delta and C nervus fibres which inhibit pain transmission at the dorsal horn of the spinal column. Heat modalities besides cause vasodilation, raise tissue repair, increase tissue extensibility, and decrease muscle tone and spasms. Based on this, oestrus modalities can promote tissue healing and therapeutic motility, however, should not be used during the acute inflammatory stage of healing.

Parameters:

For a therapeutic issue, aim to heat tissues to approximately 45 degrees celsius. Specific parameters to attain this temperature will depend on the kind of heating modality that you are using.

Contraindications:

Do not apply estrus modalities to large areas resulting in increased cadre temperature in patients who are pregnant or have cardiac disease. Do not employ over malignancy, recently radiated tissues, infection, bleeding tissues, area of impaired apportionment, inflamed tissues, rut-sensitive peel disease e.g. eczema, severe edema, or reproductive organs. Do not utilise rut modalities for patients with hemorrhagic disorder, deep vein thrombosis, dumb sensation or cognition.

Cold

What is information technology?

Common cold agents are modalities that cool superficial tissues, and deeper tissues if applied for a long enough period of time. Examples include ice packs (this warms up quickly and therefore are not recommended), crushed ice, ice water bath, coolant spray, quick ice, cool whirlpool and contrast baths.

What is it used for?

Cold modalities are used for the treatment of acute injury to reduce hurting, cause vasoconstriction which prevents inflammation, finish bleeding, reduce muscle spasms, and reduce the risk of secondary injury to tissues due to hypoxia after injury past slowing down tissue metabolism.

Parameters:

When using crushed ice, utilise over a clammy towel, non direct on the pare, for 10 minutes to modulate pain, or for xviii - 20 minutes to cool deep tissue and forbid inflammation. For other common cold modalities, refer to their manuals for instructions.

Contraindications:

Do not apply common cold modalities to a person with a cold allergy, Raynaud's affliction, cryoglobulinemia or hemoglobinemia. Practice non apply over an expanse of impaired circulation, chronic wounds, regenerating nerves, tissues impacted by tuberculosis, inductive neck and carotid sinus. Do not apply cold modalities to a person with a hemorrhagic disorder, deep vein thrombosis or impaired sensation and cognition.

Ultrasound

What is it?

Ultrasound therapy is the commitment of loftier-frequency mechanical energy to tissues via vibration of a transducer, either with thermal or not-thermal effects depending on the parameters used.

What is information technology used for?

Ultrasound affects tissues at the cellular level resulting in an accelerated inflammatory process and a practiced surround for tissue repair. Thermal ultrasound has the additional effect of heating tissues, resulting in the effects described above for heating modalities (i.e. vasodilation, enhanced tissue repair, increased tissue extensibility and decreased muscle tone and spasms), merely should not be applied during the acute inflammatory phase of healing. Athermal ultrasound may exist applied during the astute stage.

Parameters:

Ultrasound should be applied on a continuous setting to produce thermal furnishings, and on a pulsed setting for non-thermal effects.

For continuous ultrasound, intensity should exist fix between 0.8-2 Westward/cm SATP, simply merely every bit high equally is necessary for the patient to feel some rut, and should exist practical for 10-xv minutes per 10cm .

Pulsed ultrasound means that information technology is on for a percent or ratio of the fourth dimension, known as the duty bicycle. Pulsed ultrasound should be set at a duty cycle of xx% aka 1:iv on-off ratio and at an intensity of 0.1-0.2 W/cm SATA  (ie. average intensity) or 0.5-one W/cm SATP (i.e. peak intensity). (Tip: SATA is 20% of SATP because nosotros utilize a 20% duty bicycle.) Pulsed ultrasound should exist applied for 10-fifteen minutes per 10-xv cm . For either continuous or pulsed ultrasound, set the frequency to 3 Hz to treat superficial tissues, or 1 Hz to treat deeper tissues (three-5 cm depth). Apply ultrasound gel to the skin and and so motion the ultrasound head over the tissue that you wish to treat at a speed of 2-4 cm/s. Ensure the ultrasound head is flat on the tissue surface.

Contraindications:

Do not utilize ultrasound therapy over the eyes, abdomen during pregnancy, testes, malignancy, vascular insufficiency, center, acute infection/sepsis or bleeding tissues. Additionally, exercise not use thermal ultrasound if the patient lacks sensation or may accept difficulty communicating if they feel discomfort. Be cautious of applying ultrasound over implanted electronic devices and metal and plastic implants.

Electrical Stimulation

Transcutaneous Electric Nerve Stimulation (TENS)

What is information technology?

TENS is the use of relatively depression frequency, pulsed electrical currents applied to the skin via electrodes.

What is information technology used for?

TENS is used to temporarily relieve pain. Conventional TENS (C-TENS) depolarizes A-beta nerve fibres which leads to reduced nociceptive inputs to the spinal string, modulating the ascending sensory pathway. Acupuncture-like TENS (A-TENS) depolarizes A-delta and C fibres which activates the descending sensory pathways and results in the release of endogenous opioids. Both methods consequence in reduced pain feel, still C-TENS is typically trialled beginning equally it is less intense. It is possible that A-TENS has longer-lasting effects than C-TENS, however this is debated in the literature. TENS units can be relatively cheap making them more than accessible to patients who wish to self-administrate TENS at habitation to salve pain.

Parameters:

C-TENS is described as "low intensity / loftier frequency" since amplitude (intensity) should but be raised until the patient feels a sub-noxious tingling sensation, and frequency is set betwixt 80-120 Hz. Pulse duration should be fix at 150-200 microseconds (µs). Hurting relief from C-TENS occurs mainly while it is existence used, lasting maximum 20 minutes after, only it can be applied as long equally the patient wants (with peel checks every so often). Electrodes should exist placed over the area of pain, bracketing the hurting, over the dermatome, or over muscles at the corresponding spinal level.

A-TENS is described as "loftier intensity / low frequency" since aamplitude should be gradually increased to quite a loftier point at which non-painful musculus twitching occurs, but the frequency is set low between 3-ten Hz. Pulse duration should be fix at 250 µs. A-TENS should exist administered for 15-30 minutes and may be repeated subsequently 4 hours, as needed, only it should not be administered every bit frequently every bit C-TENS. Electrodes should be placed over the dermatome, trigger points or acupuncture points.

Contraindications:

Do not utilize TENS over electrically sensitive back up systems, chest wall if the patient has a center condition, autonomic plexus if the patient is hyper/hypotensive, abdomen/lumbar area if the patient is pregnant, carotid sinus, thrombosis, neoplastic neoplasm, infected tissue, hemorrhaging tissue, or if the patient has a history of seizures.

Interferential Current (IFC)

What is it?

IFC is similar to TENS in that it uses electrical currents to modulate pain. Still, while TENS utilizes one relatively depression-frequency current, IFC involves two medium frequency currents (4 electrodes) that interfere with 1 another below the skin, creating a resultant low-frequency current within painful deep tissues in order to modulate hurting.

"Why is the frequency of these modalities important?", you lot may ask. Information technology is important because

1. Research indicates that low-frequency currents attune pain.
2. Skin impedance (resistance) is inversely correlated to a current'due south frequency. This means that there is loftier skin impedance to a low-frequency current, making low-frequency currents (e.1000. TENS) uncomfortable and it difficult for the electric current to penetrate to deep tissues.

IFC uses medium frequency currents instead, which accept lower pare impedance, making it a more comfortable modality, particularly when treating deeper tissues or larger areas. The key is that IFC results in a depression-frequency current within the tissue, and therefore it is able to modulate pain while beingness more comfortable. (This is the theory backside IFC, but it is debated somewhat in the literature.)

What is information technology used for?

IFC is used to temporarily relieve pain, especially in deeper tissues or big handling areas.

Parameters:

IFC involves 2 currents. 1 is set at a carrier frequency of 4000 Hz, and the second electric current is set at a slightly higher frequency, known as the Amplitude Modulated Frequency (AMF). The parameters can be set for immediate pain relief or more than intensely, for longer pain relief (similar to C-TENS vs A-TENS).

For acute pain relief, the carrier frequency should be set to 4000 Hz, and the AMF to lxxx-120 Hz (i.e. the frequency of the 2nd current is 4080-4120 Hz). The second electric current tin stay at one frequency or sweep within the range of frequencies, gradually increasing for six seconds and so gradually decreasing for six seconds.

For longer pain relief, the carrier frequency is too gear up to 4000 Hz, while the AMF is prepare lower at 1-10 Hz. The frequency sweep should occur abruptly so that the frequency of the second current is relatively loftier (i.due east. 10 Hz) for 6 seconds and low for 6 seconds.

For both methods, apply the modality for twenty-xxx minutes. Self-agglutinative pad electrodes, pad electrodes with sponges, or suction electrodes with sponges can be used and should be placed over the area of pain, bracketing the pain, over the dermatome, or over muscles at the respective spinal level. If using the suction electrodes, apply constant suction for acute hurting relief, and intermittent suction for longer pain relief.

Contraindications:

Exercise non utilise IFC with an ice pack, over an area of impaired sensation or if the patient may take difficulty understanding or communicating if they are experiencing discomfort. Do not use small-scale electrodes every bit this may atomic number 82 to tissue damage/burns. Do non apply IFC over electronic implants, the abdomen / lumbar areas if the patient is pregnant, deep vein thrombosis, hemorrhaging tissue, infection, damaged skin, anterior neck or area of malignancy within the past six months.

Neuromuscular Electrical Stimulation (NMES)

What is it?

NMES is the application of electrical currents via electrodes to stimulate intact lower motor neurons in order to activate paretic/paralyzed muscles.

What is information technology used for?

NMES can be used to strengthen specific muscles or to activate a group of muscles in a specific sequence to assistance a patient in conveying out a functional task (e.grand. grasping an object). This sub-blazon of NMES is known as functional electrical stimulation (FES). NMES can help manage spasticity, and act every bit neuroprosthesis (eastward.g. activating ankle dorsiflexors instead of using a traditional ankle-foot orthosis to address drop pes). Because of the to a higher place applications for NMES, it is normally used in neuro rehab, when treating a patient after a stroke or spinal cord injury.

Parameters:

NMES utilizes a symmetrical biphasic waveform. At the beginning and end of each muscle activation cycle, there should be a ramp time of 1-ii seconds during which the electric current gradually turns on and off.

• To improve musculus strength (upwardly to grade iii MMT): The frequency of the current should exist set up at 50 Hz and pulse elapsing at 300 µs. At that place should be an "on" time of ten seconds (including ramp upwardly and down) when the musculus will contract and an "off" time of 50 seconds when the muscle will relax. When determining the amplitude, slowly increase the intensity until the muscle fully contracts and then gear up the machine at this amplitude. Have the patient do x-fifteen repetitions of muscle contractions, or less if the musculus is fatigued earlier.
• To improve muscle endurance: Frequency should exist set between 25-thirty Hz (which is lower than forcefulness training, to prevent early muscle fatigue) and pulse duration at 300 µs. There should be an "on" fourth dimension of 10 seconds (including ramp time), and an "off" time of 12 seconds. This ratio can be progressed to thirty seconds on, 2 seconds off. Increment the intensity slowly until an amplitude that causes the muscle to fully contract. Administer this treatment for 10-fifteen minutes, progressing to multiple hours per day. Stop when the musculus fatigues.
• To manage spasticity: Use a frequency of 35-50 Hz and pulse duration of 150-200 µs for modest muscles or 200-350 µs for large muscles. On and off time should exist the same length, between 2-5 seconds including ramp time. As above, increase the aamplitude until a full wrinkle is elicited. Use the electrical stimulation to a spastic muscle to fatigue information technology or to an antagonist muscle to cause reciprocal inhibition of the spastic musculus. The duration of treatment should be 10-thirty minutes, every 2-3 hours until the spasticity is decreased.

For all of the above methods, identify one electrode over the motor indicate (area of easiest excitability of a muscle) or nerve supply to the relevant musculus, and the other electrode distally.

For functional activities or for utilise as a neuroprosthesis, utilize an FES modality that is manufactured for that specific chore, and review the instructions for applicable parameters.

One central principle nigh NMES that is important to remember:

the patient must actively try to engage the muscles when the modality is on, in order to promote optimal motor learning.

Contraindications:

Do not apply NMES over electrically sensitive support systems, carotid sinus, chest wall, major autonomic plexus in a patient that is hypo/hypertensive, thrombus, malignancy, infection, abdominal/lumbar/pelvic area of a significant patient, or over craniofacial/cervical areas if the patient has a seizure history. Do not apply NMES to a patient that lacks sensation or has cognitive impairments that may go far difficult for them to empathise or communicate if they are experiencing discomfort. Do not use NMES within 10 meters of a shortwave diathermy device.

Iontophoresis

What is it?

Iontophoresis is the employ of electrical electric current to promote the absorption of medications across the skin. Positively charged ions in cationic medications are repelled across the skin by the anode (negative electrode). Negatively charged ions in anionic medications are repelled beyond the pare by the cathode (positive electrode).

What is it used for?

Iontophoresis may be used to transdermally utilize anesthetics, antibiotics, anti-inflammatories and various other medications that are prescribed by a physician when the use of an oral medication, topical cream or needle is not advisable or possible (e.g. needle phobia, avascular tissue). It is too used to treat hyperhidrosis (excessive sweating) and to reduce hypertrophic scars.

Parameters:

Iontophoresis utilizes a Galvanic electric current (i.e. direct current, flows in one management). The total dose is typically 40mA*min, which is the amplitude of electric current flowing, multiplied by time during which the electric current is flowing. Nonetheless, in order to make up one's mind what amplitude to use, it is important to be aware of a concept called current density, which is the concentration of the current. Excessive current density may result in burns. A safe current density is betwixt  0.1-0.3 mA/cm , though these numbers are debated in the literature. To calculate an appropriate amplitude, you may utilize the following equation:

Amplitude (mA) = safe current density (mA/cm) x electrode area (cm)

Next, calculate the treatment time required to deliver the total dose at the amplitude you have adamant above.

Treatment time (minutes) = full dose (mA*min) / amplitude (mA)

When applying iontophoresis, place one electrode over the surface area of desired medication delivery, and the other electrode over a remote site. The remote electrode tin be larger than the electrode over the treatment area, to disperse the current.

Contraindications:

Exercise not use iontophoresis over open skin, temporal/orbital regions,  implants and anterior chest of cardiac patients. Practise not utilize iontophoresis if the patient has skin allergies, an allergy to ions, impaired sensation or cerebral impairments that may make it difficult for them to understand or communicate if they are experiencing discomfort.

Light Amplification from Stimulated Emission of Radiation (LASER)

What is it?

Laser therapy is the use of a specific kind of light applied to the pare to treat pain and inflammation and promote tissue healing. Light from a laser is unique in that it is monochromatic (1 colour, has a narrow bandwidth), collimated (low-cal waves are all parallel and then the low-cal does not spread) and coherent (calorie-free waves are the same frequency and in phase i.e. peaks and valleys coincide).

For therapeutic purposes, there are "cold" and "hot" types of lasers.

Cold lasers are known as depression-level light amplification by stimulated emission of radiation therapy and accept a ability of less than 0.5 Due west, while hot lasers are known as high power laser therapy and take a ability of greater than 0.5 Due west. The theory behind light amplification by stimulated emission of radiation therapy is that chromophores (molecules in melanin and hemoglobin) blot specific wavelengths of energy that are emitted by a laser, and this absorbed energy helps to activate enzymes and promote chemical reactions needed for cell function and tissue healing.

What is it used for?

Light amplification by stimulated emission of radiation therapy can exist used to treat a range of conditions due to its ability to reduce pain and inflammation and promote tissue healing. Hot lasers also produce thermal effects such as vasodilation and enhanced tissue repair.

Parameters:

Lower wavelength and frequency lite penetrate tissue more deeply. Therefore, lasers with a wavelength between 600-1300 nm are typically used in physiotherapy treatment. More specifically, common types of lasers are scarlet waveband (600-700 nm) and infrared waveband (700-950 nm) lasers.

At that place is more than than one method to calculate treatment dose and time and there is a argue in the literature over which ane to use. One method is as follows.

i. Determine the power density (West/cm ) of your light amplification by stimulated emission of radiation: Power density (W/cm )  = average power (Westward) / beam spot size (cm )

2. Choose an advisable dose (energy density, J/cm ) that you wish to deliver to the tissues based on practice guidelines or manufacturers' instructions.

3. Calculate the time required to deliver this dose to 1 handling point, considering the energy density of your laser: Treatment time (seconds) = free energy density (J/cm ) / power density (W/cm )

Note: Joules = Watts * seconds. Therefore, the units in the equation abolish out, leaving seconds equally the unit for treatment time.

When providing laser therapy, ensure that y'all and your patient wearable goggles that are made for the wavelength of your light amplification by stimulated emission of radiation, to prevent injury to the eyes.

Contraindications:

Do not utilize laser therapy over the optics, abdomen during pregnancy, a malignancy (avert moles), acute hemorrhage, thrombosis/phlebitis, cervical autonomic plexus or an implanted pacing device. Do not provide laser therapy to a patient with hypersensitivity to light or epilepsy/seizure disorder, who is taking immunosuppressants, or who has dumb sensation or cerebral impairments that may arrive hard for them to empathise or communicate if they are experiencing discomfort.

Conclusion

The primal to using EPAs finer is agreement how they tin be used equally an offshoot to your broader programme of intendance. We hope this blog has been informative and helpful in reviewing ordinarily used EPAs and will help yous empathise when and how they can be employed to promote meliorate outcomes for your patients. Skillful luck!

Thermal Agents
Oestrus Heat tissues to ~ 45 degrees celsius. Specific parameters will depend on the kind of heating modality you lot are using, refer to the manufacturer'southward instructions.	Cold Utilise crushed ice over a damp towel for: x minutes to modulate hurting 18-20 minutes to cool deeper tissues/prevent inflammation Specific parameters for other cold modalities will depend on the kind of modality being used, refer to the manufacturer's instructions.
Ultrasound
Non-thermal ultrasound Mode: pulsed Duty cycle: i:4 or 20% Intensity: 0.five-1 W/cm SATP or 0.1-0.2 W/cm SATA Frequency: 1 Hz for deep tissue, iii Hz for superficial tissues Time: ten-15 minutes per 10 cm	Thermal ultrasound Manner: continuous Intensity:  0.8-two W/cm SATP, commencement at 0.8 until the patient feels heat and then do not increment further. Frequency: 1 Hz for deep tissue, 3 Hz for superficial tissues Time: 10-xv minutes per 10cm
TENS
C-TENS Frequency: lxxx-120 Hz Pulse duration: 150-200 µs Intensity: Increment slowly until the patient feels a sub-baneful tingling sensation Time: Equally long as necessary Electrode placement: Over the surface area of pain, bracketing the pain, over the dermatome, or over muscles at the respective spinal level	A-TENS Frequency: iii-10 Hz Pulse duration: 250 µs Intensity: Increase slowly until a non-painful muscle twitching occurs. Time: 15-30 minutes, mayhap repeated later on 4 hours, as needed. Electrode placement: Over the dermatome, trigger points or acupuncture points
IFC
Acute pain relief IFC Carrier frequency: 4000 Hz AMF: 80-120 Hz Frequency sweep: Gradual half dozen sec. up, gradual 6 sec. down Time: 20-thirty minutes Electrode placement: Over the area of pain, bracketing the pain, over the dermatome, or over muscles at the corresponding spinal level. If using suction electrodes: Constant suction	Longer-term pain relief IFC Carrier frequency: 4000 Hz AMF: 1-x Hz Frequency sweep: Abrupt, 6 sec. high, gradual half-dozen sec. depression Time: 20-30 minutes Electrode placement: Over the surface area of hurting, bracketing the pain, over the dermatome, or over muscles at the respective spinal level. If using suction electrodes: Intermittent suction

NMES
Strength Waveform: Symmetric biphasic Frequency: 50 Hz Pulse duration: 300 µs On: Off ratio: x:50 seconds Ramp upward/down: 2 seconds Amplitude: Slowly increment until muscle fully contracts Repetitions: x-15 reps, less if musculus fatigued Location of electrodes: One electrode over the motor point or nerve supply to the relevant muscle, and the other electrode distally.	Endurance Waveform: Symmetric biphasic Frequency: 25-30 Hz Pulse elapsing: 300 µs On: Off ratio: 10:12 seconds, progress to 30:2 seconds Ramp up/down: 2 seconds Aamplitude: Slowly increment until musculus fully contracts Time: 10-xv minutes, progress to hours Location of electrodes: One electrode over the motor betoken or nerve supply to the relevant muscle, and the other electrode distally.	Spasticity Frequency: 35-50 Hz Pulse duration: 15-200 µs for pocket-size muscles or 200-350 µs for big muscles On: Off ratio: 2-5: 2-5 seconds, should exist the aforementioned amount of fourth dimension on vs off Ramp upwards/down: minimum i second Amplitude: Slowly increase until muscle fully contracts Time: 10-thirty minutes, every 2-iii hours, until spasticity decreased. Location of electrodes: Apply one electrode to spastic musculus or its antagonist muscle, over the motor point or nerve supply to the relevant muscle, other electrodes distally.
Iontophoresis
Current type: Galvanic/direct Full dose: 40mA*min Condom electric current density: 0.i-0.3 mA/cm Amplitude (mA) = rubber electric current density (mA/cm) 10 electrode area (cm) Treatment time (minutes) = total dose (mA*min) / aamplitude (mA) Electrode placement: Place ane electrode over the expanse of desired medication commitment, and the other electrode over a remote site. Note, the second electrode tin exist larger, to disperse the current.
Light amplification by stimulated emission of radiation
Wavelength: 600-1300 nm, east.g. red waveband (600-700 nm), infrared waveband (700-950 nm) lasers Power density (Westward/cm)  = average power (West) / beam spot size (cm) Dose i.east. energy density is measured in J/cm. Refer to practice guidelines or manufacturers' instructions. Treatment time per point (seconds) = energy density (J/cm) / ability density (Westward/cm)

Disclaimer: Embodia Inc and the authors of this document are not responsible for the application of the above modalities in patients, which should be performed accordingly and safely at the sole discretion and responsibility of the clinician.

References

Cotler, H. B., Chow, R. T., Hamblin, M. R., & Carroll, J. (2015). The Use of Depression Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ orthopedics & rheumatology , ii (5), 00068. https://doi.org/ten.15406/mojor.2015.02.00068

ELECTROPHYSICAL AGENTS - Contraindications And Precautions: An Evidence-Based Arroyo To Clinical Decision Making In Physical Therapy. (2010). Physiotherapy Canada. Physiotherapie Canada, 62(5), 1–80. https://doi.org/10.3138/ptc.62.5

Gabison, S. (2019). Laser [PowerPoint slides]. Department of Physical Therapy, University of Toronto.

Gabison, S. (2019). Musculoskeletal Physiotherapy I: Electrophysical Agents (EPAs) Manual. Department of Physical Therapy, University of Toronto.

Gabison, S. (2020). Specialized Currents and Modalities, Unit of measurement eight [PowerPoint slides]. Department of Physical Therapy, University of Toronto.

Goats G. C. (1990). Interferential current therapy. British periodical of sports medicine, 24(ii), 87–92. https://doi.org/10.1136/bjsm.24.2.87

Johnson M. (2007). Transcutaneous Electrical Nerve Stimulation: Mechanisms, Clinical Application and Show. Reviews in pain , i (ane), 7–11. https://doi.org/10.1177/204946370700100103

Rawat, S., Vengurlekar, S., Rakesh, B., Jain, South., & Srikarti, G. (2008). Transdermal delivery past iontophoresis. Indian journal of pharmaceutical sciences , 70 (1), 5–ten. https://doi.org/x.4103/0250-474X.40324

Takeda, Chiliad., Tanino, M., & Miyasaka, H. (2017). Review of devices used in neuromuscular electrical stimulation for stroke rehabilitation. Medical devices (Auckland, N.Z.) , 10 , 207–213. https://doi.org/x.2147/MDER.S123464

---

Blog writers: Bella Levi, MScPT student; Debra Posluns, MScPT student; Linnea Thacker, MScPT student

cartercarn1964.blogspot.com

Source: https://www.embodiaapp.com/blog/288-a-comprehensive-guide-to-electrophysical-agents-epas

Share this post